Positive Valence System Function and Reward Exposure Therapy for Late-Life Depression - Administrative Supplement

晚年抑郁症的正价系统功能和奖赏暴露疗法 - 行政补充

• 批准号: 10724357
• 负责人: Jennifer N Bress
• 金额: $ 5.8万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10724357
• 关键词: Administrative Supplement; Adult; Affective; Age; Aging; Anhedonia; Area; Back; Behavior; Behavior Therapy; Behavioral; Biological Markers; Brain; COVID-19 impact; COVID-19 pandemic; Clinical; Clinical Trials Design; Collaborations; Communities; Complement; Consultations; Data; Depressed mood; Disease remission; Economic Burden; Elderly; Emotional; Event-Related Potentials; Feedback; Functional disorder; Generations; Geriatric Psychiatry; Goals; Impairment; Individual; Intervention; Knowledge; Longevity; Major Depressive Disorder; Manuals; Manuscripts; Matched Group; Measures; Mediating; Mediator; Mental Depression; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Methods; Neurobiology; Outcome; Parents; Participant; Patient Self-Report; Physiology; Positive Valence; Preparation; Psychophysiology; Psychotherapy; Quality of life; Reporting; Research; Research Domain Criteria; Research Personnel; Research Project Grants; Research Training; Rewards; Sample Size; Series; Severities; Stimulus; Supportive care; System; Techniques; Time; Training; Ventral Striatum; age group; age related; biosignature; career; career development; comparison group; depressive symptoms; design; effective therapy; experience; geriatric depression; high risk; improved; indexing; learning community; machine learning method; neural; novel; opioid user; parental role; patient engagement; peer; predicting response; recruit; research study; response; reward processing; skills; suicidal risk; sustained attention; trait; Administrative Supplement; Adult; Affective; Age; Aging; Anhedonia; Area; Back; Behavior; Behavior Therapy; Behavioral; Biological Markers; Brain; COVID-19 impact; COVID-19 pandemic; Clinical; Clinical Trials Design; Collaborations; Communities; Complement; Consultations; Data; Depressed mood; Disease remission; Economic Burden; Elderly; Emotional; Event-Related Potentials; Feedback; Functional disorder; Generations; Geriatric Psychiatry; Goals; Impairment; Individual; Intervention; Knowledge; Longevity; Major Depressive Disorder; Manuals; Manuscripts; Matched Group; Measures; Mediating; Mediator; Mental Depression; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Methods; Neurobiology; Outcome; Parents; Participant; Patient Self-Report; Physiology; Positive Valence; Preparation; Psychophysiology; Psychotherapy; Quality of life; Reporting; Research; Research Domain Criteria; Research Personnel; Research Project Grants; Research Training; Rewards; Sample Size; Series; Severities; Stimulus; Supportive care; System; Techniques; Time; Training; Ventral Striatum; age group; age related; biosignature; career; career development; comparison group; depressive symptoms; design; effective therapy; experience; geriatric depression; high risk; improved; indexing; learning community; machine learning method; neural; novel; opioid user; parental role; patient engagement; peer; predicting response; recruit; research study; response; reward processing; skills; suicidal risk; sustained attention; trait

Project Summary/Abstract The goal of the proposed K23 Mentored Patient-Oriented Research Career Development Award is to provide the PI with the mentorship, theoretical knowledge, and research skills to develop into a fully independent psychophysiological researcher studying biomarkers of depression that can be used as targets for novel interventions. In consultation with her mentors, the PI has recruited a team of expert consultants to guide her in executing a research project and training plan that will provide experience essential to her goals. The proposed study will be conducted in the Weill Cornell Institute of Geriatric Psychiatry. The study focuses on late-life depression because it is prevalent and has negative outcomes. Existing treatments have low response rates and are rarely used correctly in the community due to their complexity. The project is based on the premise that focused treatments targeting biosignatures of specific neural abnormalities will have the greatest impact on clinical outcomes in late-life depression. It concentrates on positive valence systems, which are vulnerable to aging and often impaired in depression. The project will investigate positive valence systems in older adults with major depression receiving Engage, a psychotherapy designed to reactivate reward system functions. Engage has been found efficacious in late-life depression and easy to learn by community-based therapists. Consistent with RDoC methods, the proposed study will examine target engagement of Engage in 35 depressed older adults (age ≥ 60) during a 9-week course of Engage therapy, using three units of analysis to assess positive valence system function: physiology (event-related potentials), self-reports, and behavior. It will compare Engage-treated participants with 35 depressed participants, group-matched on age, receiving manualized supportive therapy. Additional analyses will assess whether low baseline positive valence function, or increases in positive valence function during treatment, predict improvement of anhedonia with Engage, and whether reward function mediates change in anhedonia. The proposed training plan complements the research study with individualized tutorials, formal coursework, research collaborations, and manuscript preparation that will provide the PI with knowledge and skills in several areas: 1) Age-related neurobiological changes in the positive valence system and related networks; 2) Advanced statistical techniques to identify distinct neural abnormalities in depressed individuals based on their ERP profiles; and 3) Clinical trial design for psychotherapeutic interventions. The proposed project may provide important information about target engagement and mechanisms of a biologically informed, easily implemented treatment for late-life depression that has potential for dissemination. It will also provide pilot data for an R-series study using machine learning methods to predict response to Engage and will serve as an important stepping-stone for the PI as she prepares for an independent research career.

项目摘要/摘要 拟议的K23指导的面向患者的研究职业发展奖的目标是 为PI提供心态，理论知识和研究技能，以完全发展为 独立的心理生理研究人员研究抑郁症的生物标志物，可以用作目标的目标 新颖的干预措施。在与她的导师协商时，PI招募了一个专家顾问团队来指导 她执行一个研究项目和培训计划，该计划将为她的目标提供必不可少的经验。 拟议的研究将在威尔·康奈尔（Weill Cornell）老年精神病学研究所进行。研究 专注于晚期抑郁症，因为它很普遍并且具有负面结果。现有治疗方法 由于其复杂性，响应率低，很少在社区中正确使用。该项目基于 关于以特定神经异常的生物签名的重点治疗的前提将具有 对晚期抑郁症的临床结果的影响最大。它集中于正价系统， 容易衰老，并且经常在抑郁症中受损。该项目将调查正价系统 在患有严重抑郁症接受参与的老年人中，旨在重新激活奖励系统的心理治疗 功能。在晚年抑郁症中发现了有效的参与效率，并且易于学习 治疗师。与RDOC方法一致，拟议的研究将检查参与的目标参与 在9周的参与疗法期间，35名抑郁症老年人（年龄≥60岁），使用三个分析单位 评估正价系统功能：生理（事件相关电位），自我报告和行为。它 将比较经过参与处理的参与者与35名沮丧的参与者，年龄匹配，接受 手动支持的治疗。其他分析将评估低基线正价函数是否 或在治疗过程中提高正价功能，预测通过参与的anhedonia的改善， 奖励功能是否介导了Anhedonia的变化。 拟议的培训计划通过个性化的教程，正式完成了研究 课程工作，研究合作和手稿准备，将为PI提供知识和 在几个领域的技能：1）正价系统和相关年龄相关的神经生物学变化 网络； 2）高级统计技术以识别抑郁症患者中不同的神经异常 根据他们的ERP概况； 3）心理治疗干预措施的临床试验设计。提议 项目可能会提供有关目标参与和生物学机制的重要信息 知情的，容易实施具有传播潜力的晚年抑郁症的治疗方法。它也会 使用机器学习方法为R系列研究提供试验数据，以预测对参与的反应 在为独立研究生涯做准备时，她是PI的重要垫脚石。